When communicating with the social worker and seeking assistance in the specific problems, any person waits for understanding of his problems and confidence that the social worker is a professional with wide knowledge of different cultural features.
This paper describes requirements for the specialists working in such a field of social work as a hospital social work. It points skills that are implied in the light of cultural competence issue and the impact the cultural training has on building a trust relationship between the patient, its family and social workers based on the clear awareness of possible peculiarities in cultural background of the persons. It should be mentioned that hospital social work is a sub-discipline of a social work. Hospital or medical social workers having a degree in this field are employed in the hospitals, medical centers and hospices, and provide psychological assistance to the patients in the form of supportive counseling, psychotherapy or grief counseling. Hospital social worker is a team player together with the other medical representatives, such as physicians, nurses, physical therapists working for the sake of the primacy interests of the patient, his or her health.
Hospital social workers must possess the following crucial qualities and skills, such as compassion, listening and organizational skills, problem-solving skills and time-management skills. Hospital social workers provide their services mostly in the stressful and time constraint circumstances. With the aim to help the patients with the challenges, they meet when the treatment hospital social workers have to listen to carefully and understand patients’ needs showing all their empathy and compassion. Moreover, “social workers need to continuously reflect on their values and how these values may affect their interactions with clients from foreign countries” (Reardon, 2012).
Cultural competence and its components
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Cultural competence is an ability to communicate and interact with the representatives of various cultures. It includes four components: cross-cultural skills, awareness of differences between the cultural view of the social worker himself and the cultural worldview of other persons, as well as experience in awareness of a variety of cultural practices. Effective communication, understanding and interaction with people with different cultural background are core tasks of the cultural competence training for the hospital social worker (Reardon, 2012).
According to the National Alliance of Mental Illness (2012) cultural competence in any field of social work is a deep knowledge and understanding of different cultural contexts and sensitive work with the representatives of such diverse cultures. Researches from the National Alliance of Mental Illness gathered challenging information from the leading governmental organizations, such as the U.S. Census Bureau and Commonwealth Fund on the projections in the U.S. demographic characteristics. They stated that 50% of all U.S. population will be represented by American Indians, African Americans, Latinos and Asian Americans by 2050. Moreover, one-third of Hispanic patients and one-fourth of Asian Americans indicated that they experienced cultural gap during communication with doctors or medical social workers. “15% of African Americans, 13% of Hispanics, and 11% of Asian Americans said there had been a time when they felt they would have received better care if they had been of a different race or ethnicity” (National Alliance of Mental Illness, 2012).
Taking into account the above mentioned statistics, demographic composition of workers in a social work should be mentioned. Women comprise of 79% among all employed social workers. 50 years is a median age of the social worker members of NASW. 91% of all social workers are graduates with the Master’s degree. The average working experience equals to 16 years from the date of the first social degree obtaining. Concerning the ethnic or racial origin, number of whites/Caucasians accounts for more than 87%, number of African Americans amounts to 5%, Hispanics and Asian Americans represent 2% and Native Americans and Mexican Americans equal to 1%. “Two-thirds (66%) of regular members reported being married, 8% reported having domestic partners, and one-fourth (25%) are single” (National Association of Social Workers, 2003).
According to the National Association of Social Workers (2011), social workers depending on the desired status should have the following mandatory educational achievements. A certified social worker must attend 20 hours of continuing education with the one-fourth dedicated to the ethics issues. Licensed social worker, as well as licensed clinical social worker, must have additional 10 hours for the education, including 5 hours for the ethics questions and 3 hours for the issues concerning cultural competence.
Trainings on cultural competence as a part of social education program positively affect the efficiency of the hospital social work. whereas they solve misunderstanding or prejudice problems in the cultural context. After the completing of such a training, hospital social worker becomes more aware of the cultural characteristics in particular age, gender, ethnicity, nationality, education, religion, sexual orientation, family values, socioeconomic status and unique characteristics of culture, he is more loyal to the cultural differences appeared. Moreover, the hospital social worker possesses the knowledge in multicultural counseling theories, cultural conflicts resolving, understands the nature of biases, intentional or unintentional discrimination and oppression, prejudices in cultural context (Abrams & Moio, 2009).
In the study provided by the National Association of Social Workers (2012), it is stated that the importance and necessity of the cultural competence education as the form of being aware of individual social, cultural, language and economic features differentiating from culture to culture rose in recent years. Dealing with the complex problems of diverse U.S. ethnic population is an opportunity and challenge for the hospital social workers. The authors pointed an importance of understanding, correct interpretation of minorities groups’ interests, and gave a bright example of the practical application of cultural competence in the hospital social work. It was the case of Latina social worker who had a brother with schizophrenia speaking only Spanish. “When her brother failed to receive culturally competent care over a 20-year period, he was hospitalized 162 times. When he finally did receive culturally competent care, he was hospitalized only once in 15 years” (National Association of Social Workers, 2012).
Beliefs of Abrams and Moio
Abrams and Moio (2009) stated “cultural competence is a fundamental tenet of professional social work practice” (p.245). Cultural competence network includes two correlated ideological directions: cross-cultural skills development and self-awareness. It is important to encourage students who are studying social work and practicing hospital social workers to become “aware of the origins and development of their personal values and worldviews with regards to differences, so that their deeply rooted and, perhaps, unconscious beliefs can be recognized and subsequently set aside, or “bracketed,” in the helping exchange” (p. 247).
Standards of cultural competence
The importance of the cultural competence education is highlighted in the standards of cultural competence developed by the National Association of Social Workers (2001). Ten fundamental standards: self-awareness, ethics and values, cross-cultural knowledge and skills, service delivery, diverse workforce, professional education, language diversity and cross-cultural leadership, empowerment and advocacy are pointed. The authors underlined that social workers should apply knowledge of different cultural backgrounds and demonstrate competence in the provision of sensitive services to the clients. Moreover, social worker should undergo the appropriate training and seek to understand diversity in person’s social background, such as race, ethnicity, national origin, color, marital status, religion and other factors.
Reardon (2012) states that healthcare organizations search for the culturally competent hospital social workers who will be able to assist in dealing with patients-immigrants. The authors emphasizes that there is a need to improve “skills, such as empathetic listening, patient empowerment, and relationship building that can be applied to people of all cultures” (Reardon, 2012). It is a clear position of the patients from other cultures that if they are misunderstood or not understood, they are not safe. Therefore, hospital social worker should demonstrate his wide knowledge of various features of different cultures and assure the patient’s or his representatives and their thoughts, beliefs, customs and values will be interpreted correctly and will be considered in the proposed recommendations given by the hospital social worker. The author gave an example of a Philadelphia-based social worker, Annie Stanfield-Hagert, who completed numerous trainings on cultural competence. She made an emphasis that, such simple things as clothing or nonverbal communication form the hospital social worker’s perception. This can lead to the fact that the patient of other culture could misinterpret the behavior of the social worker and would not disclose all needed information about his concerns and fears perceiving the behavior of the hospital social worker as offensive or regarding it as a sign of low education or belonging to the low class. It is also crucial to take into consideration the role of family in the patients’ cultures and the decision-making process about any issues including the health ones.
The knowledge and understanding of cultural competence core principles should be delivered through the comprehensive training of hospital social workers, whereas psychological assistance in dealing with the health care problems and psychological aspects that arise are one of the most crucial fields. These are the fields where false interpretation, misunderstanding, applying unconsciously one’s own biases or stereotypes to the representatives of different races, religions, ethnicities and nationalities could result in poor patients’ service outcomes.